Glomb Nicolaus W, Shah Manish I, Kosoko Adeola A, Doughty Cara B, Galapi Cafen, Laba Bushe, Rus Marideth C
Emergency Medicine, University of California, San Francisco School of Medicine, San Francisco, California, USA.
Pediatric Emergency Medicine, Baylor College of Medicine, Houston, Texas, USA.
BMJ Simul Technol Enhanc Learn. 2020 Sep 3;6(5):279-283. doi: 10.1136/bmjstel-2019-000501. eCollection 2020.
As emergency medical services (EMS) systems develop globally in resource-limited settings, equipping providers with paediatric training is essential. Low-fidelity simulation-based training is an effective modality for training healthcare workers, though limited data exist on the impact of such training programmes. The objective of this study was to evaluate the paediatric portion of a simulation-based curriculum for prehospital providers in Botswana.
This was a prospective cohort study of EMS providers from more populated regions of Botswana, who attended a 2-day training that included didactic lectures, hands-on skills stations and low-fidelity simulation training. We collected data on participant self-efficacy with paediatric knowledge and skills and performance on both written and simulation-based tests. Self-efficacy and test data were analysed, and qualitative course feedback was summarised.
Thirty-one EMS providers participated in the training. Median self-efficacy levels increased for 13/15 (87%) variables queried. The most notable improvements were observed in airway management, newborn resuscitation and weight estimation. Mean written test scores increased by 10.6%, while mean simulation test scores increased by 21.5% (p<0.0001). One hundred per cent of the participants rated the course as extremely useful or very useful.
DISCUSSION/CONCLUSION: We have demonstrated that a low-fidelity simulation-based training course based on a rigorous needs assessment may enhance short-term paediatric knowledge and skills for providers in a developing EMS system in a limited-resource setting. Future studies should focus on studying larger groups of learners in similar settings, especially with respect to the impact of educational programmes like these on real-world patient outcomes.
随着全球紧急医疗服务（EMS）系统在资源有限的环境中不断发展，为急救人员提供儿科培训至关重要。基于低保真模拟的培训是培训医护人员的一种有效方式，不过关于此类培训项目的影响的数据有限。本研究的目的是评估博茨瓦纳针对院前急救人员的基于模拟的课程中的儿科部分。
这是一项对来自博茨瓦纳人口较多地区的急救人员进行的前瞻性队列研究，他们参加了为期两天的培训，包括理论讲座、实践技能站和低保真模拟培训。我们收集了参与者在儿科知识和技能方面的自我效能数据以及笔试和基于模拟测试的表现数据。对自我效能和测试数据进行了分析，并总结了课程的定性反馈。
31名急救人员参加了培训。所询问的15个变量中有13个（87%）的自我效能水平中位数有所提高。在气道管理、新生儿复苏和体重估计方面观察到最显著的改善。笔试平均成绩提高了10.6%，而模拟测试平均成绩提高了21.5%（p<0.0001）。100%的参与者将该课程评为极其有用或非常有用。
讨论/结论：我们已经证明，基于严格需求评估的基于低保真模拟的培训课程可能会提高资源有限环境中发展中的急救系统中急救人员的短期儿科知识和技能。未来的研究应侧重于在类似环境中研究更大规模的学习者群体，特别是此类教育项目对实际患者结果的影响。
